In mid 2014, health-care services in Liberia were being overwhelmed by the largest-ever outbreak of Ebola virus disease. Transmitted through contact with the bodily fluids of an infected person, the disease was spreading at a rate of 80 new cases per week by the end of July, killing up to 70% of the people it infected. The country’s fragile health-care system, damaged by a 14-year civil war, could not respond to all of the demands it faced. The rate of new infections rose, and schools and health facilities closed. Collaborating with international partners and five months into the epidemic, the Liberian government created a dedicated Incident Management System (IMS) to coordinate all elements of the country’s fight against the disease. The IMS team created a clear decision-making framework, provided responders with adequate infrastructure and technical support, and set up a coherent procedure for communicating with a frightened and anxious public. At the end of the outbreak, the question was whether Liberia’s approach had provided a model for managing responses to infectious disease outbreaks in other, similar settings or whether the approach had left room for making the system work better.

Leon Schreiber drafted this case study in consultation with Jennifer Widner of Princeton University based on interviews conducted in Monrovia, Liberia and London in November and December 2015.

Princeton University’s Grand Challenge supported the research and development of this case study, which is part of a series on public management challenges in the West African Ebola Outbreak response.